The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy

Please cite this article as: Tabibi A, Kashi AH, Mirjalili SAM, Mahmoudnejad N, Kashani P, Salavatipour B, Soltani MH. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy. Novel Biomed 2013;1(2):43-47.Objectives: To evaluate the possibility of access to the kidneys from posterior axillary line (PAL) in supine position for percutaneous nephrolithotomy.Materials and Methods: 102 consecutive patients who were candidated for abdominal CT scan, enrolled in this study. In cases of impossible access, the point on the posterior surface of body which permitted safe access was determined and the percent of movement toward body midline (relative to PAL) was calculated (M.PER).Results: Percutaneous access was simulated from upper and middle calyces of the kidney in 13% and 75% of cases, respectively. Access to the lower region was possible in 90% of right and 79% of left lower calyces, respectively (p=0.03). In cases with impossible access from PAL, the M.PER for a safe access was 46-47% for upper region and 34- 38% for middle and lower calyces of the kidney (P = 0.0001).Conclusions: Access to upper calyces from PAL was limited in some cases regarding to the presence of solid organs. Presence of colon made access impossible in the lower right and left calyces in about 10% and 20% of cases, respectively. In upper region, more deviation toward midline was necessary to establish a safe access compared with middle and lower calyces

Importance of long non-coding RNAs in the pathogenesis, diagnosis, and treatment of prostate cancer

Long non-coding RNAs (lncRNAs) are regulatory transcripts with essential roles in the pathogenesis of almost all types of cancers, including prostate cancer. They can act as either oncogenic lncRNAs or tumor suppressor ones in prostate cancer. Small nucleolar RNA host genes are among the mostly assessed oncogenic lncRNAs in this cancer. PCA3 is an example of oncogenic lncRNAs that has been approved as a diagnostic marker in prostate cancer. A number of well-known oncogenic lncRNAs in other cancers such as DANCR, MALAT1, CCAT1, PVT1, TUG1 and NEAT1 have also been shown to act as oncogenes in prostate cancer. On the other hand, LINC00893, LINC01679, MIR22HG, RP1-59D14.5, MAGI2-AS3, NXTAR, FGF14-AS2 and ADAMTS9-AS1 are among lncRNAs that act as tumor suppressors in prostate cancer. LncRNAs can contribute to the pathogenesis of prostate cancer via modulation of androgen receptor (AR) signaling, ubiquitin–proteasome degradation process of AR or other important signaling pathways. The current review summarizes the role of lncRNAs in the evolution of prostate cancer with an especial focus on their importance in design of novel biomarker panels and therapeutic targets

Investigation of dissipation flow in the urban Canyon

With the wind permanent flow in the cities, obtaining the minimal pollution in the environment is accessible. Different policies have been considered for optimization of cities such as attachment and or reduction of building parts like air-traps, ceiling forms and so on. Due to population growth in cities and the increasing need for resettlement these people in the cities, inevitably, to the high-rise buildings have gone. The people living in high-rise buildings to meet the needs of their vital urban open spaces are forced to use. To have knowledge about air pollution through buildings, the CFD based software of Envi-met is used. In this case, we can say that the best angle to transfer pollution is the angle of 30 degrees. Also in an ideal case with imposed changes in the form, we could enhance the problem by better navigation of inside wind of urban canyons into spaces between blocks of buildings that have the capacity to trap the particles. Final it is found that we may be able to have more optimal results for transition of pollutions by suitable orientation of blocks against the wind direction of blow

Evaluating Percutaneous Nephrolithotomy-Induced Kidney Damage by Measuring Urinary Concentrations of β-2 Microglobulin

PURPOSE: To assess percutaneous nephrolithotomy (PCNL)-induced kidney tubular damage and the associated factors.MATERIALS AND METHODS: One hundred and eight patients who have undergone PCNL from May 2007 to October 2007 were recruited in this study. Urinary level of β2-microglobulin (Uβ2MG) was measured on the day before the operation as well as on the 1st, and 7thpost PCNL days. Percutaneous nephrolithotomy was performed using standard method. Patients’ demographic and peri-operative data were collected to evaluate factors influencing renal injury.RESULTS: Median urinary levels of β2-microglobulin on pre-operative, 1st, and 7thpostoperative days were 0.2 mg/dL (range, 0.1 to 82), 0.4 mg/dL (range, 0.2 to 97), and 0.2 mg/dL (range, 0.2 to 114), respectively. High levels of Uβ2MG (> 2.3 mg/dL) were observed in 10 (9%), 20 (19%), and 10 (9%) patients pre-operatively and on the 1st, and 7thpostoperative days, respectively. In multivariable analysis, Uβ2MG on the 1stpostoperative day was associated with pre-operative serum creatinine level (P < .001) and diabetes mellitus (P = .05), while Uβ2MG on the 7thday after the operation was associated with pre-operative serum creatinine level (P = .01), diabetes mellitus (P = .01), and PCNL time (P = .02).CONCLUSION: Percutaneous nephrolithotomy does not cause kidney tubular injury beyond one week. In patients with pre-operative high serum creatinine concentration, diabetes mellitus, and/or long operation time, the likelihood of the kidney damage is higher than others

Newer advances in access

This chapter starts with an overview of the commonly used access direction technologies namely fluoroscopy and ultrasonography. Then an overview of the main novel technologies for access has been provided starting from visual inspection of the access tract using the optical needle. The optical needle has a primary success rate of only 66% in targeting the desired calyx on the first attempt. Then, fluoroscopy-based novel technologies including three-dimensional reconstruction of the access tract anatomy using preoperative computed tomography data by Urodyna CT and other fluoroscopy-based technologies have been reviewed. Urodyna CT has been associated with a high dose of radiation to the patient and also with a steep learning curve. iPAD-assisted PCNL reconstructs bodily organs using preoperative CT scan and uses augmented reality to reveal access tract of PCNL and organs within it by an iPAD software. Afterward, novel ultrasonography-based technologies including 3D ultrasonography, use of Doppler ultrasonography for improvement of access, and the combination of ultrasonography with electromagnetic navigation have been overviewed. The best success rate of ultrasonography has been observed with Sonix GPS technology which resorts to both ultrasonography and electromagnetic navigation and with a first attempt success rate of 100%. Afterward, the concept of electromagnetic navigation has been presented. Electromagnetic navigation has been associated with a 100% success rate on the first attempt in a preliminary study on human subjects and is a promising technology in the future

Effect of Processed Honey and Royal Jelly on Cancer-Related Fatigue: A Double-Blind Randomized Clinical Trial

Background: Cancer-related fatigue (CRF) is experienced by 50% to 90% of cancer patients and can severely affect their quality of life and functional capacity. Several randomized trials have recommended various ways to alleviate the symptoms of CRF with or without recourse to medications. Objective: The aim of this study is to evaluate the effectiveness of processed honey and royal jelly on the symptoms of CRF in cancer patients who are undergoing hormone therapy, chemotherapy, chemo-radiation, or radiotherapy. Methods: Fifty-two participants from the patients who visited the oncology clinic of Shohada-e-Tajrish hospital in Tehran (Iran) between May 2013 and August 2014 were selected and divided into two groups. The study group (26 patients) received processed honey and royal jelly, while the control group received pure honey. Both groups were instructed to consume their 5mL supplement twice daily for 4 weeks. Both groups were assessed at the beginning of the study, after 2 weeks, and then at the end of 4 weeks of treatment. Fatigue was measured using a visual analogue fatigue scale (VAFS) and fatigue severity scale (FSS). The results were compared between the two arms of study, and equality of probability distributions was assessed using a Kolmogorov–Smirnov test. Results: The mean age of the 52 patients was 54.84. After two and four weeks of treatment with processed honey and royal jelly, VAFS and FSS due to treatment was better in the study group than in the control group, and the http://www.ephysician.ir Page 2476 differences were statistically significant (p<0.001, p<0.001, respectively). Conclusion: To the best of our knowledge, our study provided support for the use of processed honey and royal jelly to ameliorate CRF. The positive results of this study warrant further studies in this field. Clinical Trial Registration: The study was registered in the Iranian Clinical Trial Registry Center (http://www.irct.ir) with the registration code: IRCT2015081423426N1. Funding: The authors received no financial support for the research, authorship, and/or publication of this article

The experience of a tertiary referral center with laparoscopic pyelolithotomy for large renal stones during 18 years

Abstract This study aimed to evaluate the outcomes of laparoscopic pyelolithotomy, including its efficacy and feasibility in treatment of large renal stones. All patients who underwent laparoscopic pyelolithotomy operations in a referral center were enrolled from 2003 to 2020. The final analysis included 436 patients. The total stone free rate was 88.3% and the stone-free rate for staghorn/multiple stones versus other types of stones was 81% vs. 91% (P = 0.002). Likewise, the total operation duration was 158 ± 50 and the operation duration for staghorn/multiple stones versus other types of stones was 171 ± 51 min vs. 153 ± 49 min (P < 0.001). The operation duration (169 ± 51 vs. 155 ± 58 vs. 155 ± 42 min) and hospitalization (4.5 ± 2.3 vs. 4.0 ± 2.2 vs. 3.6 ± 1.8) decreased with increasing the surgeons' experience over time. The outcomes of laparoscopic pyelolithotomy for children versus adults versus geriatric patients and in patients with normal versus abnormal kidney anatomy did not reveal statistically significant differences. Laparoscopic pyelolithotomy could be employed as an alternative surgical approach for patients with large kidney stones of any age or with kidney abnormalities provided that appropriate expertise is available to carry out the procedure